Volume 2 Number 1

This 3rd edition which has 8 articles on topics such as; Continuing Formal Education, Stress and Coping Strategies; and The Effects of Stigma on Mental Health Nurses, just to mention a few, promises to be educative.

Non - professional nurses are trained to assist professional nurses to perform their duties. In – service training programmes are designed to augment the knowledge of these nursing assistants in the profession, but they yearn to pursue continuing formal education to upgrade their professional and academic qualification. The purpose of this study was to find out factors that motivate non - professional nurses to continue their education. The qualitative exploratory descriptive design was employed to explore the experiences of non–professional nurses with continuing formal education. Twenty three (23) participants were purposively selected for the study, and a semi-structured interview guide with open - ended questions was used in gathering data from December 2016 to January 2017. The findings from the study indicated that non–professional nurses are motivated to continue their education because they had low academic qualifications, lacked professional competencies, were self-determined to progress in life, their employers recognized a higher academic qualification than several years of working experience and they were practicing outside their job descriptions. The study concludes that staff development plans should be designed by employers and educational institutions responsible for the training of non–professional nurses should have flexible programmes to enhance access.

Contraceptive use is an important intervention in reducing unplanned pregnancies and other sexually transmitted infections (STIs). This study investigates the knowledge of contraceptive use, identify the barriers of contraceptive use, and determine the predictors of contraceptive use among women in a peri-urban community in Ghana. Using a cross-sectional survey design, a total of 189 women of childbearing age was sampled in a peri-urban community in Ghana. Data were collected with questionnaires and analyzed using chi-square and binary logistic regression. The result shows that more than half of the participants ( 63.6% (n = 56) of contraceptive users knew seven to twelve types of contraceptives, whereas 46.6% of non-contraceptive users indicated they knew seven to twelve types of contraceptives. Knowledge of the types and uses of contraceptive was significantly associated with contraceptive usage. Spousal consent, adverse effects, lack of knowledge about the benefits and religion were the main barriers to contraceptive use. There was a strong association between marital status, income, age and contraceptive use among women (p<0.05). Women with no children and women with one to two children were 7 times (95%CI, 2.00, 27.78) more likely to use contraceptives. Those with more than three children were 11 times (95%CI 2.34, 54.87) more likely to use contraceptives. Although the women knew about the uses and types of contraceptives, utilisation was low. Parity was high among the factors that predicted the non-usage of contraceptives among women. The findings of this study call for a comprehensive education on contraceptives at various levels of the health delivery system.

In maternal health, though caesarean section (CS) has contributed significantly to reducing maternal morbidity and mortality worldwide, there are still concerns about women’s knowledge on caesarean section. Although there is an accelerating rate of caesarean section in both developed and developing countries, some recent studies have insinuated that African women have an aversion for caesarean section. Therefore, the study aimed to assess pregnant women’s knowledge towards caesarean section at the Tamale Teaching Hospital. A descriptive cross-sectional study was conducted between February to April 2017 among pregnant women attending antenatal clinic. The simple random sampling method was adopted in recruiting 360 pregnant women. The Chi square test was used to determine the associations between women’s demographics and their knowledge of caesarean section. Thirty-two percent (32%) of respondents had good knowledge regarding caesarean section, 48% and 20% had fair and poor knowledge on the procedure respectively. There was significant association between knowledge on caesarean section and respondents’ characteristics (education p=0.035, gravida p=0.012, and previous CS p=0.001). Even though there was a high awareness level (80%) among women who attended antenatal clinic, there was a low level of knowledge on caesarean section. Women’s preferred mode of delivery was influenced by their knowledge of the indications for CS and the perceived consequences of the procedure. Education should target women without formal education and primigravida as well as men since they are the major decision makers in most families in developing countries.

Adequate knowledge, attitude, and practices are effective in providing baseline preventive measures in diabetes. This study determined the knowledge, attitude and practices of diabetic patients towards dietary modification. This descriptive cross-sectional study was conducted at Ejisu-Juaben municipality, Ghana. A structured questionnaire was used to obtain information such as socio-demographic and knowledge, attitude and practices of diabetic patients towards dietary modification. In all, 200 diabetic participants were recruited. The majority of the participants (84.0%) were between the ages 40-60 years. Ninety-two (46.0%) of the participants correctly identified dietary modification as a way of adjusting to healthy eating practices. Forty percent (40.0%) of the participants knew that adjusting to dietary modification help maintain blood sugar to a near normal. Most of the participants (43.0%) knew that non-compliance to dietary modifications can increase blood sugar level. Eighty six (86.0%) of the patients knew that dietary modification could help control their diabetic complications. Most (89.0%) of the participants sometimes adhere to dietary modifications, 11.0% regularly adhere while 10.0% do not adhere to dietary modifications. Diabetic patients had adequate knowledge about their disease conditions but had poor attitude and practice towards dietary modifications. Frequent public health and hospital-based education on adjusting to dietary modifications is required.

Information on maternal experience with institutional birth is dearth in Ghana, and the few studies on this subject did not employ standardized internationally validated questionnaires/instruments. Using a structured questionnaire including a modified-Women’s Views of Birth Labour Satisfaction Questionnaire four (WOMBLSQ4), this study seeks to evaluate women’s birth experience with care during labour, birth, and lying-in period, at the University of Ghana Hospital in Accra. Using a quantitative cross-sectional study approach, 50 puerperal women in the lying-in ward and those seeking postnatal care less than three months after delivery at the University of Ghana Hospital were selected. A structured questionnaire comprising, amongst others, the internationally validated Women’s Views of Birth Labour Satisfaction Questionnaire fourth edition (WOMBLSQ4) was administered to respondents. In general, the maternal satisfaction with birth experience at the University of Ghana Hospital was high, with 52% and 38% of mothers rating their overall experience as excellent and good respectively. However, 20% of the participants expressed dissatisfaction with their overall birth experience at the health facility. Partner support received the highest negative rating on the birth experience accounting for 18% followed by continuity of care where 16% of the respondents reported not knowing their caregivers at the time of delivery. Though positive maternal birth experience among respondents was high, steps need to be taken to reduce the gaps in care identified by this study.

Menopause is a natural process that every woman at a particular point in time experiences. Menopausal experience comes with certain symptoms some of which appear stressful. This study sought to understand the experiences and management of menopause in Walewale in northern Ghana. The study design was qualitative, and the technique of data collection was an in-depth interview. Fifteen participants within the menopausal age were selected for the study using the purposive sampling technique. The data was audio recorded and later transcribed for analysis, using content analysis. The majority of the participants understood menopause as a natural process. However, some of them conceptualized it as a disease. Participants, in recounting their individual account of menopausal symptoms, espoused varying degree of experiences including hot flushes, sexual disinterest, memory problems, mood swings, headaches, muscles and joint pain and aches, and abdominal pains. The management was individualized but some claimed they saw the symptoms as normal occurrences. Others stated that they tried remedies like self-medication, exercise, and consumption of good diet as part of their management strategies. Based on the above, it is important that public enlightenment and community-based interventions be undertaken to increase women's awareness regarding menopause.

Nurses have been found to experience high levels of stress which contributes to health challenges and decreases their efficiency. Nurse managers may experience higher levels of stress due to their complex and multi-faceted roles and responsibilities. A quantitative descriptive cross-sectional approach was used to identify how nurse managers experience stress and strategies used to reduce stress. Three hospitals were randomly selected, and 45 nurse managers were also selected using disproportionate stratified sampling technique. Simple random sampling was employed to select 15 nurse managers from each hospital. Structured questionnaire was used for data collection, and the data was analyzed using both inferential and descriptive statistics to describe the sample and determine factors that influence stress. The study revealed that common causes of stress among nurse managers are lack of break period during shifts (95.6%), staff shortage (97.8%), inadequate support from management (93.3%), poor working conditions (91.1%) and inadequate resources (91.1%). The major predictor of stress among nurse managers is the type of unit (F = 9.546, p < .05, R2 = .205). Headache (78.3%), backache (73.9%) and fatigue (82.6%) are the major physical stress experienced by nurse managers. Frustration (84.8%) is the major emotional stress experienced by nurse managers and the major type of psychological stress experienced by nurse managers is lack of concentration (67.4%). The major coping strategies of stress among nurse managers are expression of feelings instead of bottling them up (91.1%), accepting the things one cannot change (88.9%) and time management (86.7%) whereas eating excessively is the least mechanism (8.9%) used to cope with stress. It is recommended that nurse managers should mature in age, practice, knowledge and experience to cope better with the challenges that confront their position. Nurse managers should also take intermittent breaks during shifts, and hospitals.

Society’s perception of the causes of mental disorder is one of the factors that influence how thementally ill is treated. Stigma affects not only people with mental illnesses but nurses and other professionals working with individuals diagnosed with mental illness. This study assessed the effect of stigma on mental health nurses. A cross-sectional descriptive design was adopted for this study, and a structured questionnaire was used to collect data from 101 mental health nurses. Data was analyzed and summarized descriptively using frequency tables and graphs. An inferential analysis was conducted by Pearson Product Moment of correlation and Independent sample t test. The results show that the respondents perceive stigma to stem largely from the society. Females reported a higher level of stigma and discrimination from the general public than males. The majority of the participants view stigma as discrimination. Public education and expansion of community care are important measures to reduce the effects of stigma and discrimination.

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Parents have the responsibility to teach their adolescent children how to deal with sexual problems confronting them by educating them on what they need to do to avoid risky sexual behaviours. This study explored the socio-cultural factors affecting parents’ role in educating their young children on sex and sexuality. The study used an exploratory descriptive qualitative design and employed focus group discussions (FGD) and in-depth interviews to explore the socio-cultural factors that affect parents’ presentation on sexuality to adolescents. Thirty-four parents made up of two mothers’ groups, one fathers’ group and a mixed group (mothers and fathers) took part in the FGDs. In-depth interviews were conducted with ten parents who were not part of the FGDs. The data was transcribed and analysed manually. The findings of this study indicated that parents blamed cultural taboos for preventing them from discussing sexuality with adolescents. Parents however supported school sex education for their children and indicated that it would benefit adolescents whose parents could not discuss sexual issues with them. Parents proposed that the school should involve them in school sexual education for them to be acquainted with what the children are taught in school in order to complement it at home. All the parents were worried about the negative influence that the media have on adolescents. In spite of obvious impediments to discussions on sexuality with adolescents, parents saw the need to discuss sexuality with adolescents because of the benefits of such education.

Tuberculosis (TB) treatment continues to be a daunting task in most low and middle-income countries due to cultural beliefs held by people and inadequate information about the importance of treatment adherence in the community. This study explored the patient-related factors influencing tuberculosis treatment adherence, with a focus on patient-related factors affecting such treatment adherence. Using a semi-structured interview guide, 10 participants (Five males, five females) were engaged in in-depth individual interviews. Miles and Huberman’s (1994) content analysis approach was used to analyse data. Three main themes emerged from the synthesised data: Knowledge on TB and its treatment, challenges associated with TB treatment and motivating factors to adherence. Patients’ belief about the cause of TB such as spiritual forces, poor knowledge about treatment duration and consequences of defaulting, and the side effect of drugs especially when taken with little or no food were found to be critical factors that negatively impacted treatment adherence. The desire to attain one’s ‘normal self’, making up mind to complete treatment and recognition of symptom improvement following the commencement of treatment supported adherence to TB treatment. Continuous education on TB and counselling during treatment are vital interventions that need sustained integration in TB prevention and adherence programmes. Maintaining continuous multi-level support for clients living with TB is critical for TB prevention and control, and adherence to full treatment course.

Breast milk provides additional protection to children less than five years against infections. In the last few decades, exclusive breastfeeding has received a growing interest as the appropriate feeding method for infants all over the world. The aim of the study was to identify family belief systems and practices that influenced infant feeding during the first six months of life among rural women in Sagu, in the Upper West Region of Ghana. An exploratory, qualitative research design was employed to obtain in-depth information required to understand and interpret family belief systems and practices that influence exclusive breastfeeding among 27 participants. Data were collected between August and September, 2016. The study found family belief systems and practices such as gender, social role, culture and religious beliefs as factors influencing exclusive breastfeeding among women. Family heads were key in decision-making regarding infant feeding. The findings showed that mothers faced multifaceted cultural and religious beliefs, gender relations and sociostructural factors that influenced their decision making regarding breastfeeding. Grandfathers, grandmothers and fathers have an important role in infant feeding decisions in rural communities; however, they required prior knowledge to provide optimum support to breastfeeding mothers. Public health education on exclusive breastfeeding is required among significant others in the family. Further research is required to explore cultural beliefs and practices influencing exclusive breastfeeding and how they can be modified to promote public interventions particularly in matters relating to exclusive breastfeeding.

Gestational diabetes mellitus (GDM) is a medical condition that occurs during pregnancy. This study sought specifically to determine the awareness of pregnant women on GDM. It also assessed the knowledge level of pregnant women on GDM and determined whether there was a correlation between educational level and knowledge of GDM. The study utilised the quantitative method. A cross-sectional design was used to investigate the awareness and knowledge of pregnant women on GDM. The research setting for the study was at the Tema General Hospital. The study population included all pregnant women who attended antenatal clinic at the hospital for routine maternal health services in February 2015. The average monthly antenatal attendance was 500 pregnant women and 250 respondents were chosen through simple random sampling.

Statistical Package for Social Sciences (SPSS) version 21 was used to analyse the data. The study revealed that majority of respondents was aware of GDM. The sources of awareness included television, radio, newspapers, friends and health personnel. The respondents had knowledge of the causes and risk factors that led to GDM.

Recommendations included the use of mass media as a tool to intensify and disseminate information about GDM and re-emphasis of causes and risk factors associated with GDM during health talks for early detection and early reporting for management.

Although catheter-associated urinary tract infection is well researched, little is known about the socio-economic impact of the use of indwelling urethral catheters, including those in Ghana. Therefore, the aim of this study was to explore socio-economic experiences by men with indwelling urethral catheters in the Volta region of Ghana. The study utilized qualitative explorative descriptive design. Data was collected from 19 participants using a semi-structured interview guide. Purposive sampling was used in recruiting participants. Content analysis was carried out. Four thematic categories were identified: interruption in activity levels, financial dependence on family, sexual restriction, and social isolation. The findings indicated that the use of indwelling urethral catheters resulted in several socio-economic consequences for clients. The authors suggested that, in order to improve the quality of life of men with indwelling urethral catheters, the same level of attention paid to catheter-associated urinary tract infections must be extended to assessing the social impact of indwelling urethral catheter usage.

Cancer is identified to be one of the leading causes of mortalities in most countries. However, some positive coping mechanisms have been discovered to help cancer patients cope with some psychological distress that accompany illness. The present study sought to examine the association between religious coping mechanisms and depression among cancer patients in Tema General Hospital. It was hypothesized that religious coping would relate negatively with depression and patients with self-directing coping strategy would be more depressed than patients with benevolent coping strategy. Data were collected from a purposively sampled 50 cancer patients at the Tema General Hospital. The findings of the study using Pearson r supported the hypotheses that the belief in religion is statistically and significantly associated with less depression among cancer Patients. It is therefore recommended that physicians, clinicians and

psychologists/counsellors adopt religious coping strategies with their patients in order to help manage and cope with their conditions.

Low and middle-income countries face challenges with retention of healthcare personnel including midwives, primarily because of migration to other countries. Repercussions from the loss of healthcare workers have been grave and the impact on healthcare services for the inhabitants is consequently compromised. Since many such countries subsidize the education of healthcare workers, the monies spent do not provide the expected return on investment. While some studies review the cause of such migrations, limited research explore the views of healthcare workers who choose to stay and work in the countries that educated them and no such studies have explored the views of midwives in particular.

The aim of this transcendental phenomenological study was to explore the views and motivations of Ghanaian-educated midwives who have chosen to remain and practice in Ghana. The study was conducted in 2015 among twelve purposively sampled Ghanaian educated midwives from a hospital in the Ashanti Region of Ghana, to explore their views about staying to work in the country, in view of what may have inspired their counterparts to leave. Data was analyzed using NVivo 10® (QSR, 2014).

The findings identified one key theme around their reasons for remaining in Ghana. Five additional themes amplified and extended the reasons and all themes provided guidance for addressing retention issues in Ghana. Context-specific recommendations were made with a focus on midwifery leadership, policy makers, stakeholders and the main professional regulatory body to address the exodus of midwives in Ghana and other LMICs.

Emotional distress associated with the death of human beings cannot be underestimated. Much as it affects the immediate family members, midwives who witness death of pregnant patients are not spared the emotional distress. Emotional distress affects the general health, behaviour, productivity and job satisfaction of nurses and midwives. However, there is inadequate literature on how midwives in the Ashanti Region of Ghana become emotionally distressed after they experience maternal death. This study sought to explore and describe lived experiences of midwives’ emotional distress over maternal death at work using a qualitative approach. The study consisted of 57 participants (18 supervisors and 39 ward midwives) selected using the purposive sampling technique. Data collection was done through focus group discussions using semi-structured interviews. The responses collected were managed by qualitative computer data analysis package (Atlas.ti version 7.1.7) and the Thematic Content Analysis was used for analyzing the data. Four major themes emerged from this study: feeling sad or bad, traumatised, disorganised, and death seen as unpleasant, painful and inhumane. Main recommendation embodied institution of support programmes in hospitals without them, to help workers cope with such distress, help lessen the distress that midwives go through, improve quality of services provided, as well as provide job satisfaction.

Abstract
Having a biological child is an essential part of marriage in northern Ghana. Women who are unable to bear their own children therefore go through psychological and social trauma. However, there is paucity of studies on the psychological and soc . . .

Abstract
This article is intended to achieve two scholarly objectives: to examine self-motivating factors that influence HIV positive mothers to breastfeed despite the known risk of infecting their babies and also to determine conditions that influence t . . .

ABSTRACT
Cerebral palsy has been identified as the most common, chronic childhood disability that causes appreciable motor deficit. Societiesâ€™ interpretion of disabling conditions affect the attitudes of members towards persons living with disabili . . .

ABSTRACT
Sick children are exposed to painful procedures on admission to health care facilities. Nurses use various strategies in the management of pain which may be pharmacological or non-pharmacological. In most cases, the strategy to be used by the nu . . .

There is paucity of literature involving caregivers of individuals with schizophrenia in Ghana. This study contributes knowledge to this field by exploring the experiences of informal caregivers of individuals with schizophrenia in the Accra metropolis. . . .

Abstract
Like the fear associated with the demise of loved ones, maternal deaths at any health facility equally illicit fear among midwives. This jeopardises their ability to achieve the quality of work expected of them. There is a depth of literature . . .

Abstract
Over the years it has been assumed that newly qualified nurses are ready to practice immediately after passing their licensure examination. However, studies have shown that, these nurses experience role performance stress, moral distress, discou . . .

Editorial Board

Dr. Mrs. Abigail Kyei

Editor-in-chief

Prof. Lydia Aziato

Deputy Editor-in-chief

Prof. Enerstina Donkor

Member

Prof. Eric Wilmot

Menber

Nii Teiko Tagoe

Member

Mrs. Mercy Avogo

Member

Nana Boateng Ageman

Member

NumidHorizon

An International Journal of Nursing and Midwifery is an official journal of the Nursing and Midwifery Council of Ghana. The journal is aimed at providing a credible peer-reviewed medium for nurses and midwives and other health related researchers to share their research and other professional works. It is an international journal published online and in print by-annually.